[URETERS INPLANTATION METHOD INTO LOW-PRESSURE SMALL INTESTINE RESERVOIR].

Urine derivation after cystectomy or due to bladder functional impairment more has been a pressing problem in urology for more than a century. Various techniques of urinary derivation after cystectomy due to bladder cancer or non-cancerous diseases have been suggested. In the present day, more often, the artificial reservoirs are formed from the various intestinal segments. The article describes preoperative preparation of patients, surgical technique and efficiency of the specific method of implantation of ureters into low-pressure small intestine reservoir. Statistical data of Al. Tsulukidze National Center of Urology since 1987 and postoperative results and recommendations are presented.

SUCCESSFUL REPAIR OF IATROGENIC URETERAL INJURY IN A PATIENT WITH ECTOPIC CROSSED AND FUSED RIGHT KIDNEY BY URETEROURETEROSTOMY.

Congenital renal malformations are the most common congenital malformations in humans, the most common being horseshoe kidney with joined lower poles present in up to 0.25% of general population. To the contrary renal fusions with ectopia are amongst the rare malformations affecting 1 in 2000 examined cadavers. Males are affected slightly more often then females (3:2), left to right crosses being more frequent. The value of early diagnosis of asymptomatic renal malformation is uncertain, except when other abnormalities might point to them and they can affect the clinical management strategy (severe ear deformity with facial malformation, gynecological abnormalities). In females concomitant abnormalities of kidneys and paramesonephric duct derivatives are common, with up to 40% of women with uterine malformations reported to have various congenital renal abnormalities. Even though there are occasional examples of surgical repair of the injured kidneys with crossed-fused malformation the majority of surgical cases resort to renal resection. We presented a rare case of complex genitourinary malformation with crossed fused disk kidney diagnosed after the iatrogenic injury to the right ureter after emergent gynecological surgery. Rare pathology and presentation was diagnosed by IVP and confirmed during operation. We have constructed an ipsilateral ureteroureterostomy to drain the right portion of fused kidney. Urinary flow was satisfactory with no significant nephrostomy tube drainage next day, allowing the nephrostomy tube removal. Postsurgical evaluation by IVP has demonstrated a good flow from both kidney and no detectable anastomotic leaks. Postsurgical recovery was uneventful. After 2 years from operation IVP data did not changed. It must be noted, that Ectopic kidneys are frequently malformed and have an abnormal ureteral drainage leading to incontinence and frequent UTIs.

Characteristics of morphological change in erythrocytes during metaststic adenocarcinoma of the prostate before and after castration.

The objective of our study was to establish whether there is a direct link between displayed changes in Erythrocytes and hormonal shifts talking place in organism. For the experimental research we used a blood serum and erythrocytes of 15 men with metastasized adenocarcinoma before castration and a blood serum and erythrocytes of 15 men in 6 months after castration, also a blood serum and erythrocytes of practically healthy men. Age of patients varied from 60-75 years. Structural observation of erythrocytes was conducted by means of light microscope method, and quantitative calculation of steroid hormones was performed by means of the method of imunopherment analysis. Deep morphological changes of erythrocytes were observed in peripheral blood during metastasized adenocarcinoma of prostate gland before and after castration. At the same time during this pathology we detected sharp quantitative change of steroid hormones of testicular and adrenal glands. It was established that the deep morphological changes of erythrocytes in peripheral blood should be related to the cancerous processes occurring in organism (direct way); It was established that during the noted pathology hormonal shifts taking place in organism (indirect way) influence the course of erythropoiesis and cause changes of surface architectonics of erythrocytes, as a result of which pathological erythrocytes -cells with altered form and low functional activity, are formed.

Erythrocyte membrane permeability in the men with metastatic adenocarcinoma of the prostate.

The aim of our study was to investigate the alterations of the erythrocyte membrane permeability in the men with metastatic adenocarcinoma of the prostate before and six months after castration. For experimental research were used the erythrocytes of 15 men with metastatic prostate cancer (Pca) (before and after 6 months from castration) and of the 15 practically healthy men (control group). The patients age was vacillate from 60 to 75 years old. Clinical stage of the disease was established at A. Tsulukidze National Center of Urology. Investigations revealed the changes of Na(+)/K(+)-ATP-ase activity and the changes of Na(+) and K(+) ions concentration in metastatic Pca patients before and six months after castration. It was determined that after the castration alterations of the erythrocytes transportive function is less pronounced in comparison with pre-operational data; These indicate the overall improvement of the organism's condition in the post-operational period and partial recovery of the cellular homeostasis.

[Diagnostics of stress-incontinence in women].

In experimental model, imitating lower urinary tract was detected the significance of urodinamic researches for diagnostic of stress incontinence. We suggested math formules for determine opening and closing of sphincter and their connection to the bladder volume, on the basis of uroflowgrame analysies, where was noted the uncontroled leakege of liquid (urine). By cystometry was detected the connection between opening of urethral sphincter and the pressure of the bladder, when was determined the stress incontinence. It was concluded that urodinamic figures have significant diagnostical value at stress incontinence and could help in choosing conservative treatment or surgery.

Dynamics of the protein spectrum changes in blood erythrocytes of male patients with prostate adenocarcinoma after plastic orchiectomy.

We have studied erythrocytes electrophoresis profiles in patients with prostate adenocarcinoma before and after plastic orchectomy and in healthy men to detect changes in the protein spectrum of erythrocytes. Our investigations have shown that during this pathology protein spectrum of erythrocytes structure undergoes substantial changes. This is demonstrated by losing of 35 KD molecular weight protein fraction and by appearance of 36 KD molecular weight protein fraction on the erythrocytes electrophoregram. It should be noted, that after plastic orchectomy we can see the relative normalization of erythrocyte's electrophoresis picture and it's approaching to the data of the control group (losing of 120 KD protein fraction and appearance of 48 KD protein fraction), which indicates to the normalization of the condition of the whole organism. It was detected that the synthesis of lower molecular protein fractions, on the one hand is influenced by rising of accantocytes percentage and on the other hand by the activation of the lipid oxidation process in erythrocytes membrane.

Prevalence of urinary incontinence in women population.

Urinary incontinence among women population is widely spread disease, it occurs in every 5th, 6th woman. The frequency of disease is rising with age. Especially high percentage of disorder occurs in older respondents (60 years and >). Urinary incontinence is not only a medical, but also a social problem. Therefore, this disease is very actual problem and needs earlier revealing and exact diagnostic for timely and correct treatment. Data of our epidemiological researches corresponds to the foreign reference data.

Dynamics of the structural and electrical characteristics of erythrocytes in men with metastatic adenocarcinoma of the prostate before and after plastic orchiectomy.

The changes of electrophoretic mobility of erythrocytes in the practically healthy men and in men with metastatic prostate cancer before and after castration were studied. The electrophoretic mobility of erythrocytes was investigated in laboratory conditions by Kharamanenko and Abramson micro methods. Experimental data were processed by means of standard variation statistics MINITAB (Basic statistic) p